Today, if a retinal condition is suspected in an infant or toddler, the challenge to the ophthalmologist is to enable the child to achieve and maintain ocular fixation long enough for proper examination. To obtain a precise retinal examination, the choices are placing a child under general anesthesia (with many risks, such as pneumonia and potential death), perform a limited examination, or worse, to wait until the child grows older to identify what is wrong. For adults, where fixation and cooperation are usually not an issue, a technology known as optical coherence tomography (OCT) is used to provide 3-dimensional, and magnified cross-sectional images of the retina (e.g., images depicting the macula—FIG. 1). This standard of care for outpatient diagnosis and management of retinal disease in adults is generally well-tolerated in older children.
Most neonates can be adequately immobilized for retinal imaging, although not perfectly so. Infants, active toddlers and young children will not cooperate for such imaging, and thus a more suitable version of the OCT instrument is needed. Indeed, there may also be patients in other age groups unable to sit and hold still for such imaging. It is distressing that treatable retinal conditions in young children and those who cannot cooperate with traditional OCT exams are frequently missed because of this situation.
Due to the large amount of data needed to be processed after acquisition, conventional OCT (including spectral domain OCT and even Swept Source OCT) does not allow monitoring of the 2D/3D images in real time. This means that in the context of young children and those unable to cooperate for OCT imaging, several seconds of 3D data need to be first collected blindly, without information as to whether the OCT system's image includes the fovea (the most sensitive and critical retinal region, in the center of the macula), i.e. without knowing whether or not the child is actually looking at the intended target.
Accordingly, there is a need in the art for a system and method configured to obtain OCT images, specifically, during confirmed foveal fixation.